Pyogenic liver abscess in pediatric populations in beijing (2008-2023)

• Published in: BMC infectious diseases Vol. 24; no. 1; pp. 745 - 8
• Main Authors: Xie, Yue, Guo, Ling-Yun, Liu, Bing, Hu, Hui-Li, Hu, Bing, Chen, Tian-Ming, Qian, Su-Yun, Hei, Ming-Yan, Liu, Gang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29.07.2024; BioMed Central; BMC
• Subjects: Abdomen; Abscess; Abscesses; Adolescent; Anemia; Anti-Bacterial Agents - therapeutic use; Antibiotics; Appendicitis; Bacterial pneumonia; Beijing - epidemiology; Blood; Care and treatment; Child; Child, Preschool; Children; Comorbidity; Congenital diseases; Development and progression; Diagnosis; Disease; E coli; Female; Fever; Health aspects; Hematology; Humans; Immune system; Immunodeficiency; Infant; Infections; Intubation; Klebsiella; Klebsiella pneumoniae - isolation & purification; Liver; Liver Abscess, Pyogenic - epidemiology; Liver Abscess, Pyogenic - microbiology; Liver cirrhosis; Liver diseases; Magnetic resonance imaging; Male; Metagenomics; Methicillin; Metronidazole; mNGS; Next-generation sequencing; Pathogen; Pathogens; Patients; Pediatrics; Pneumonia; Primary immunodeficiencies; Pyogenic liver abscess; Regression analysis; Retrospective Studies; Risk Factors; Staphylococcus aureus - isolation & purification; Ultrasonic imaging; Veins & arteries; Beijing; China; Beijing China; United States > US; Taiwan; Children; Antibiotics; Pathogen; Pyogenic liver abscess; mNGS
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-09634-0

Data on pyogenic liver abscess (PLA) of children in China have been limited. We aimed to summarize the clinical feather, microbiological characteristics, management, and outcome of PLA in children. We retrospectively reviewed PLA cases from January 2008 to June 2023 at Beijing Children's Hospital. Clinical characteristics, pathogens and management were analyzed. We diagnosed 57 PLA patients in our center. The median onset age was 4.5 years and the male-to-female ratio was 1.6:1. The median diagnostic time was nine days and the median length of stay was 22 days. Twenty-eight patients (49.1%) had predisposing factors, around 71.4% of the patients had malignant hematology and primary immunodeficiency disease. Patients with underlying factors were more likely to have extrahepatic organ involvement (p = 0.024), anemia (p < 0.001), single abscess (p = 0.042), unilateral involvement (p = 0.039), and small size of the abscess (p = 0.008). Twenty-four patients (42.1%) had extrahepatic organ involvement. Pathogens were identified in 17 patients (29.8%), the most common pathogens were Klebsiella pneumoniae and Staphylococcus aureus. The positive rate of metagenomic next-generation sequencing (mNGS) was 87.5% (7/8). On multivariable analysis, the extrahepatic organ involved (p = 0.029) and hepatomegaly (p = 0.025) were two independent factors associated with poor outcomes. PLA is usually seen in children with predisposing factors. Malignant hematology and primary immunodeficiency disease were the most common underlying diseases. Extrahepatic organ involvement and hepatomegaly are associated with poor prognosis. Increased use of mNGS could be beneficial for identifying pathogens.